|
DRILL BIT 3.2 MM 3-FLUTED 315.29
|
Facility
IP
|
$2,196.00
|
|
| Hospital Charge Code |
2966195
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,076.04 |
| Max. Negotiated Rate |
$2,020.32 |
| Rate for Payer: Aetna Commercial |
$1,976.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,163.88
|
| Rate for Payer: Cash Price |
$658.80
|
| Rate for Payer: Cigna Commercial |
$2,020.32
|
| Rate for Payer: Health EOS Commercial |
$1,954.44
|
| Rate for Payer: HFN Commercial |
$2,020.32
|
| Rate for Payer: Multiplan Commercial |
$1,756.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,317.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,020.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,076.04
|
| Rate for Payer: Quartz Commercial |
$1,317.60
|
| Rate for Payer: WEA Trust Commercial |
$1,207.80
|
| Rate for Payer: WPS Commercial |
$1,626.58
|
|
|
DRILL BIT 3.2 MM 3-FLUTED 315.29
|
Facility
OP
|
$2,196.00
|
|
| Hospital Charge Code |
2966195
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$614.88 |
| Max. Negotiated Rate |
$8,784.00 |
| Rate for Payer: Aetna Commercial |
$1,976.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,888.56
|
| Rate for Payer: Aetna Managed Medicare |
$614.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,427.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,098.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,054.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,163.88
|
| Rate for Payer: Cash Price |
$658.80
|
| Rate for Payer: Cigna Commercial |
$2,020.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,228.88
|
| Rate for Payer: Health EOS Commercial |
$1,954.44
|
| Rate for Payer: HFN Commercial |
$2,020.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,647.00
|
| Rate for Payer: Multiplan Commercial |
$1,756.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,317.60
|
| Rate for Payer: Preferred Network Access Commercial |
$2,020.32
|
| Rate for Payer: Quartz Beloit One Network |
$1,076.04
|
| Rate for Payer: Quartz Commercial |
$1,427.40
|
| Rate for Payer: Quartz Medicare Advantage |
$1,317.60
|
| Rate for Payer: The Alliance Commercial |
$8,784.00
|
| Rate for Payer: WEA Trust Commercial |
$1,207.80
|
| Rate for Payer: WPS Commercial |
$1,626.58
|
|
|
DRILL BIT 3.2MM X12.7CM 1/8 00-2318-032-06
|
Facility
IP
|
$874.00
|
|
| Hospital Charge Code |
5264631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$428.26 |
| Max. Negotiated Rate |
$804.08 |
| Rate for Payer: Aetna Commercial |
$786.60
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$463.22
|
| Rate for Payer: Cash Price |
$262.20
|
| Rate for Payer: Cigna Commercial |
$804.08
|
| Rate for Payer: Health EOS Commercial |
$777.86
|
| Rate for Payer: HFN Commercial |
$804.08
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: NAPHCARE Commercial |
$524.40
|
| Rate for Payer: Preferred Network Access Commercial |
$804.08
|
| Rate for Payer: Quartz Beloit One Network |
$428.26
|
| Rate for Payer: Quartz Commercial |
$524.40
|
| Rate for Payer: WEA Trust Commercial |
$480.70
|
| Rate for Payer: WPS Commercial |
$647.37
|
|
|
DRILL BIT 3.2MM X12.7CM 1/8 00-2318-032-06
|
Facility
OP
|
$874.00
|
|
| Hospital Charge Code |
5264631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$244.72 |
| Max. Negotiated Rate |
$3,496.00 |
| Rate for Payer: Aetna Commercial |
$786.60
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$751.64
|
| Rate for Payer: Aetna Managed Medicare |
$244.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$568.10
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$437.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$419.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$463.22
|
| Rate for Payer: Cash Price |
$262.20
|
| Rate for Payer: Cigna Commercial |
$804.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$489.09
|
| Rate for Payer: Health EOS Commercial |
$777.86
|
| Rate for Payer: HFN Commercial |
$804.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$655.50
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: NAPHCARE Commercial |
$524.40
|
| Rate for Payer: Preferred Network Access Commercial |
$804.08
|
| Rate for Payer: Quartz Beloit One Network |
$428.26
|
| Rate for Payer: Quartz Commercial |
$568.10
|
| Rate for Payer: Quartz Medicare Advantage |
$524.40
|
| Rate for Payer: The Alliance Commercial |
$3,496.00
|
| Rate for Payer: WEA Trust Commercial |
$480.70
|
| Rate for Payer: WPS Commercial |
$647.37
|
|
|
DRILL BIT 3.2MM X 20MM RINGLOC+ QUICK CONNECT 31-323220
|
Facility
OP
|
$1,376.00
|
|
| Hospital Charge Code |
6065701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$385.28 |
| Max. Negotiated Rate |
$5,504.00 |
| Rate for Payer: Aetna Commercial |
$1,238.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,183.36
|
| Rate for Payer: Aetna Managed Medicare |
$385.28
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$894.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$688.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$660.48
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$729.28
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cigna Commercial |
$1,265.92
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$770.01
|
| Rate for Payer: Health EOS Commercial |
$1,224.64
|
| Rate for Payer: HFN Commercial |
$1,265.92
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,032.00
|
| Rate for Payer: Multiplan Commercial |
$1,100.80
|
| Rate for Payer: NAPHCARE Commercial |
$825.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,265.92
|
| Rate for Payer: Quartz Beloit One Network |
$674.24
|
| Rate for Payer: Quartz Commercial |
$894.40
|
| Rate for Payer: Quartz Medicare Advantage |
$825.60
|
| Rate for Payer: The Alliance Commercial |
$5,504.00
|
| Rate for Payer: WEA Trust Commercial |
$756.80
|
| Rate for Payer: WPS Commercial |
$1,019.20
|
|
|
DRILL BIT 3.2MM X 20MM RINGLOC+ QUICK CONNECT 31-323220
|
Facility
IP
|
$1,376.00
|
|
| Hospital Charge Code |
6065701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$674.24 |
| Max. Negotiated Rate |
$1,265.92 |
| Rate for Payer: Aetna Commercial |
$1,238.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$729.28
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cigna Commercial |
$1,265.92
|
| Rate for Payer: Health EOS Commercial |
$1,224.64
|
| Rate for Payer: HFN Commercial |
$1,265.92
|
| Rate for Payer: Multiplan Commercial |
$1,100.80
|
| Rate for Payer: NAPHCARE Commercial |
$825.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,265.92
|
| Rate for Payer: Quartz Beloit One Network |
$674.24
|
| Rate for Payer: Quartz Commercial |
$825.60
|
| Rate for Payer: WEA Trust Commercial |
$756.80
|
| Rate for Payer: WPS Commercial |
$1,019.20
|
|
|
DRILL BIT 3.2MM X 230MM 705232
|
Facility
IP
|
$2,137.00
|
|
| Hospital Charge Code |
6177949
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,047.13 |
| Max. Negotiated Rate |
$1,966.04 |
| Rate for Payer: Aetna Commercial |
$1,923.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,132.61
|
| Rate for Payer: Cash Price |
$641.10
|
| Rate for Payer: Cigna Commercial |
$1,966.04
|
| Rate for Payer: Health EOS Commercial |
$1,901.93
|
| Rate for Payer: HFN Commercial |
$1,966.04
|
| Rate for Payer: Multiplan Commercial |
$1,709.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,282.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,966.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,047.13
|
| Rate for Payer: Quartz Commercial |
$1,282.20
|
| Rate for Payer: WEA Trust Commercial |
$1,175.35
|
| Rate for Payer: WPS Commercial |
$1,582.88
|
|
|
DRILL BIT 3.2MM X 230MM 705232
|
Facility
OP
|
$2,137.00
|
|
| Hospital Charge Code |
6177949
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$598.36 |
| Max. Negotiated Rate |
$8,548.00 |
| Rate for Payer: Aetna Commercial |
$1,923.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,837.82
|
| Rate for Payer: Aetna Managed Medicare |
$598.36
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,389.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,068.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,025.76
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,132.61
|
| Rate for Payer: Cash Price |
$641.10
|
| Rate for Payer: Cigna Commercial |
$1,966.04
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,195.87
|
| Rate for Payer: Health EOS Commercial |
$1,901.93
|
| Rate for Payer: HFN Commercial |
$1,966.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$1,709.60
|
| Rate for Payer: NAPHCARE Commercial |
$1,282.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,966.04
|
| Rate for Payer: Quartz Beloit One Network |
$1,047.13
|
| Rate for Payer: Quartz Commercial |
$1,389.05
|
| Rate for Payer: Quartz Medicare Advantage |
$1,282.20
|
| Rate for Payer: The Alliance Commercial |
$8,548.00
|
| Rate for Payer: WEA Trust Commercial |
$1,175.35
|
| Rate for Payer: WPS Commercial |
$1,582.88
|
|
|
DRILL BIT 3.2MM X 30MM RINGLOC+ QUICK CONNECT 31-323230
|
Facility
IP
|
$1,431.00
|
|
| Hospital Charge Code |
5729664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$701.19 |
| Max. Negotiated Rate |
$1,316.52 |
| Rate for Payer: Aetna Commercial |
$1,287.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$758.43
|
| Rate for Payer: Cash Price |
$429.30
|
| Rate for Payer: Cigna Commercial |
$1,316.52
|
| Rate for Payer: Health EOS Commercial |
$1,273.59
|
| Rate for Payer: HFN Commercial |
$1,316.52
|
| Rate for Payer: Multiplan Commercial |
$1,144.80
|
| Rate for Payer: NAPHCARE Commercial |
$858.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,316.52
|
| Rate for Payer: Quartz Beloit One Network |
$701.19
|
| Rate for Payer: Quartz Commercial |
$858.60
|
| Rate for Payer: WEA Trust Commercial |
$787.05
|
| Rate for Payer: WPS Commercial |
$1,059.94
|
|
|
DRILL BIT 3.2MM X 30MM RINGLOC+ QUICK CONNECT 31-323230
|
Facility
OP
|
$1,431.00
|
|
| Hospital Charge Code |
5729664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$400.68 |
| Max. Negotiated Rate |
$5,724.00 |
| Rate for Payer: Aetna Commercial |
$1,287.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,230.66
|
| Rate for Payer: Aetna Managed Medicare |
$400.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$930.15
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$715.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$686.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$758.43
|
| Rate for Payer: Cash Price |
$429.30
|
| Rate for Payer: Cigna Commercial |
$1,316.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$800.79
|
| Rate for Payer: Health EOS Commercial |
$1,273.59
|
| Rate for Payer: HFN Commercial |
$1,316.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,073.25
|
| Rate for Payer: Multiplan Commercial |
$1,144.80
|
| Rate for Payer: NAPHCARE Commercial |
$858.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,316.52
|
| Rate for Payer: Quartz Beloit One Network |
$701.19
|
| Rate for Payer: Quartz Commercial |
$930.15
|
| Rate for Payer: Quartz Medicare Advantage |
$858.60
|
| Rate for Payer: The Alliance Commercial |
$5,724.00
|
| Rate for Payer: WEA Trust Commercial |
$787.05
|
| Rate for Payer: WPS Commercial |
$1,059.94
|
|
|
DRILL BIT 3.2MM X 40MM RINGLOC+ QUICK CONNECT 31-323240
|
Facility
OP
|
$1,323.00
|
|
| Hospital Charge Code |
6178522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$370.44 |
| Max. Negotiated Rate |
$5,292.00 |
| Rate for Payer: Aetna Commercial |
$1,190.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,137.78
|
| Rate for Payer: Aetna Managed Medicare |
$370.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$859.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$661.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$635.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$701.19
|
| Rate for Payer: Cash Price |
$396.90
|
| Rate for Payer: Cigna Commercial |
$1,217.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$740.35
|
| Rate for Payer: Health EOS Commercial |
$1,177.47
|
| Rate for Payer: HFN Commercial |
$1,217.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$992.25
|
| Rate for Payer: Multiplan Commercial |
$1,058.40
|
| Rate for Payer: NAPHCARE Commercial |
$793.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,217.16
|
| Rate for Payer: Quartz Beloit One Network |
$648.27
|
| Rate for Payer: Quartz Commercial |
$859.95
|
| Rate for Payer: Quartz Medicare Advantage |
$793.80
|
| Rate for Payer: The Alliance Commercial |
$5,292.00
|
| Rate for Payer: WEA Trust Commercial |
$727.65
|
| Rate for Payer: WPS Commercial |
$979.95
|
|
|
DRILL BIT 3.2MM X 40MM RINGLOC+ QUICK CONNECT 31-323240
|
Facility
IP
|
$1,323.00
|
|
| Hospital Charge Code |
6178522
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$648.27 |
| Max. Negotiated Rate |
$1,217.16 |
| Rate for Payer: Aetna Commercial |
$1,190.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$701.19
|
| Rate for Payer: Cash Price |
$396.90
|
| Rate for Payer: Cigna Commercial |
$1,217.16
|
| Rate for Payer: Health EOS Commercial |
$1,177.47
|
| Rate for Payer: HFN Commercial |
$1,217.16
|
| Rate for Payer: Multiplan Commercial |
$1,058.40
|
| Rate for Payer: NAPHCARE Commercial |
$793.80
|
| Rate for Payer: Preferred Network Access Commercial |
$1,217.16
|
| Rate for Payer: Quartz Beloit One Network |
$648.27
|
| Rate for Payer: Quartz Commercial |
$793.80
|
| Rate for Payer: WEA Trust Commercial |
$727.65
|
| Rate for Payer: WPS Commercial |
$979.95
|
|
|
DRILL BIT 3.2 PERCUTANEOUS 324.212
|
Facility
IP
|
$2,898.00
|
|
| Hospital Charge Code |
2966197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,420.02 |
| Max. Negotiated Rate |
$2,666.16 |
| Rate for Payer: Aetna Commercial |
$2,608.20
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,535.94
|
| Rate for Payer: Cash Price |
$869.40
|
| Rate for Payer: Cigna Commercial |
$2,666.16
|
| Rate for Payer: Health EOS Commercial |
$2,579.22
|
| Rate for Payer: HFN Commercial |
$2,666.16
|
| Rate for Payer: Multiplan Commercial |
$2,318.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,738.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,666.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,420.02
|
| Rate for Payer: Quartz Commercial |
$1,738.80
|
| Rate for Payer: WEA Trust Commercial |
$1,593.90
|
| Rate for Payer: WPS Commercial |
$2,146.55
|
|
|
DRILL BIT 3.2 PERCUTANEOUS 324.212
|
Facility
OP
|
$2,898.00
|
|
| Hospital Charge Code |
2966197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$811.44 |
| Max. Negotiated Rate |
$11,592.00 |
| Rate for Payer: Aetna Commercial |
$2,608.20
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,492.28
|
| Rate for Payer: Aetna Managed Medicare |
$811.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,883.70
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,449.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,391.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,535.94
|
| Rate for Payer: Cash Price |
$869.40
|
| Rate for Payer: Cigna Commercial |
$2,666.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,621.72
|
| Rate for Payer: Health EOS Commercial |
$2,579.22
|
| Rate for Payer: HFN Commercial |
$2,666.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,173.50
|
| Rate for Payer: Multiplan Commercial |
$2,318.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,738.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,666.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,420.02
|
| Rate for Payer: Quartz Commercial |
$1,883.70
|
| Rate for Payer: Quartz Medicare Advantage |
$1,738.80
|
| Rate for Payer: The Alliance Commercial |
$11,592.00
|
| Rate for Payer: WEA Trust Commercial |
$1,593.90
|
| Rate for Payer: WPS Commercial |
$2,146.55
|
|
|
DRILL BIT 3.2 QUICK COUPLING 310.31
|
Facility
OP
|
$1,277.00
|
|
| Hospital Charge Code |
2966196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.56 |
| Max. Negotiated Rate |
$5,108.00 |
| Rate for Payer: Aetna Commercial |
$1,149.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,098.22
|
| Rate for Payer: Aetna Managed Medicare |
$357.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$830.05
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$638.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$612.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$676.81
|
| Rate for Payer: Cash Price |
$383.10
|
| Rate for Payer: Cigna Commercial |
$1,174.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$714.61
|
| Rate for Payer: Health EOS Commercial |
$1,136.53
|
| Rate for Payer: HFN Commercial |
$1,174.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$957.75
|
| Rate for Payer: Multiplan Commercial |
$1,021.60
|
| Rate for Payer: NAPHCARE Commercial |
$766.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,174.84
|
| Rate for Payer: Quartz Beloit One Network |
$625.73
|
| Rate for Payer: Quartz Commercial |
$830.05
|
| Rate for Payer: Quartz Medicare Advantage |
$766.20
|
| Rate for Payer: The Alliance Commercial |
$5,108.00
|
| Rate for Payer: WEA Trust Commercial |
$702.35
|
| Rate for Payer: WPS Commercial |
$945.87
|
|
|
DRILL BIT 3.2 QUICK COUPLING 310.31
|
Facility
IP
|
$1,277.00
|
|
| Hospital Charge Code |
2966196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$625.73 |
| Max. Negotiated Rate |
$1,174.84 |
| Rate for Payer: Aetna Commercial |
$1,149.30
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$676.81
|
| Rate for Payer: Cash Price |
$383.10
|
| Rate for Payer: Cigna Commercial |
$1,174.84
|
| Rate for Payer: Health EOS Commercial |
$1,136.53
|
| Rate for Payer: HFN Commercial |
$1,174.84
|
| Rate for Payer: Multiplan Commercial |
$1,021.60
|
| Rate for Payer: NAPHCARE Commercial |
$766.20
|
| Rate for Payer: Preferred Network Access Commercial |
$1,174.84
|
| Rate for Payer: Quartz Beloit One Network |
$625.73
|
| Rate for Payer: Quartz Commercial |
$766.20
|
| Rate for Payer: WEA Trust Commercial |
$702.35
|
| Rate for Payer: WPS Commercial |
$945.87
|
|
|
DRILL BIT 3.2 RADIOLUCENT 4200-355-032
|
Facility
IP
|
$3,281.00
|
|
| Hospital Charge Code |
3287469
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,607.69 |
| Max. Negotiated Rate |
$3,018.52 |
| Rate for Payer: Aetna Commercial |
$2,952.90
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,738.93
|
| Rate for Payer: Cash Price |
$984.30
|
| Rate for Payer: Cigna Commercial |
$3,018.52
|
| Rate for Payer: Health EOS Commercial |
$2,920.09
|
| Rate for Payer: HFN Commercial |
$3,018.52
|
| Rate for Payer: Multiplan Commercial |
$2,624.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,968.60
|
| Rate for Payer: Preferred Network Access Commercial |
$3,018.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,607.69
|
| Rate for Payer: Quartz Commercial |
$1,968.60
|
| Rate for Payer: WEA Trust Commercial |
$1,804.55
|
| Rate for Payer: WPS Commercial |
$2,430.24
|
|
|
DRILL BIT 3.2 RADIOLUCENT 4200-355-032
|
Facility
OP
|
$3,281.00
|
|
| Hospital Charge Code |
3287469
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$918.68 |
| Max. Negotiated Rate |
$13,124.00 |
| Rate for Payer: Aetna Commercial |
$2,952.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,821.66
|
| Rate for Payer: Aetna Managed Medicare |
$918.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,132.65
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,640.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,574.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,738.93
|
| Rate for Payer: Cash Price |
$984.30
|
| Rate for Payer: Cigna Commercial |
$3,018.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,836.05
|
| Rate for Payer: Health EOS Commercial |
$2,920.09
|
| Rate for Payer: HFN Commercial |
$3,018.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,460.75
|
| Rate for Payer: Multiplan Commercial |
$2,624.80
|
| Rate for Payer: NAPHCARE Commercial |
$1,968.60
|
| Rate for Payer: Preferred Network Access Commercial |
$3,018.52
|
| Rate for Payer: Quartz Beloit One Network |
$1,607.69
|
| Rate for Payer: Quartz Commercial |
$2,132.65
|
| Rate for Payer: Quartz Medicare Advantage |
$1,968.60
|
| Rate for Payer: The Alliance Commercial |
$13,124.00
|
| Rate for Payer: WEA Trust Commercial |
$1,804.55
|
| Rate for Payer: WPS Commercial |
$2,430.24
|
|
|
DRILL BIT 3.2 X 130 JACOBS CHUCK 310.32
|
Facility
OP
|
$956.00
|
|
| Hospital Charge Code |
5349209
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$267.68 |
| Max. Negotiated Rate |
$3,824.00 |
| Rate for Payer: Aetna Commercial |
$860.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$822.16
|
| Rate for Payer: Aetna Managed Medicare |
$267.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$621.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$478.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$458.88
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$506.68
|
| Rate for Payer: Cash Price |
$286.80
|
| Rate for Payer: Cigna Commercial |
$879.52
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$534.98
|
| Rate for Payer: Health EOS Commercial |
$850.84
|
| Rate for Payer: HFN Commercial |
$879.52
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$717.00
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: NAPHCARE Commercial |
$573.60
|
| Rate for Payer: Preferred Network Access Commercial |
$879.52
|
| Rate for Payer: Quartz Beloit One Network |
$468.44
|
| Rate for Payer: Quartz Commercial |
$621.40
|
| Rate for Payer: Quartz Medicare Advantage |
$573.60
|
| Rate for Payer: The Alliance Commercial |
$3,824.00
|
| Rate for Payer: WEA Trust Commercial |
$525.80
|
| Rate for Payer: WPS Commercial |
$708.11
|
|
|
DRILL BIT 3.2 X 130 JACOBS CHUCK 310.32
|
Facility
IP
|
$956.00
|
|
| Hospital Charge Code |
5349209
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$468.44 |
| Max. Negotiated Rate |
$879.52 |
| Rate for Payer: Aetna Commercial |
$860.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$506.68
|
| Rate for Payer: Cash Price |
$286.80
|
| Rate for Payer: Cigna Commercial |
$879.52
|
| Rate for Payer: Health EOS Commercial |
$850.84
|
| Rate for Payer: HFN Commercial |
$879.52
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: NAPHCARE Commercial |
$573.60
|
| Rate for Payer: Preferred Network Access Commercial |
$879.52
|
| Rate for Payer: Quartz Beloit One Network |
$468.44
|
| Rate for Payer: Quartz Commercial |
$573.60
|
| Rate for Payer: WEA Trust Commercial |
$525.80
|
| Rate for Payer: WPS Commercial |
$708.11
|
|
|
DRILL BIT 3.2 X 145MM 3-FLUTED NEEDLE POINT 03.010.103S
|
Facility
IP
|
$2,523.00
|
|
| Hospital Charge Code |
2966198
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,236.27 |
| Max. Negotiated Rate |
$2,321.16 |
| Rate for Payer: Aetna Commercial |
$2,270.70
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,337.19
|
| Rate for Payer: Cash Price |
$756.90
|
| Rate for Payer: Cigna Commercial |
$2,321.16
|
| Rate for Payer: Health EOS Commercial |
$2,245.47
|
| Rate for Payer: HFN Commercial |
$2,321.16
|
| Rate for Payer: Multiplan Commercial |
$2,018.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,513.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,321.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,236.27
|
| Rate for Payer: Quartz Commercial |
$1,513.80
|
| Rate for Payer: WEA Trust Commercial |
$1,387.65
|
| Rate for Payer: WPS Commercial |
$1,868.79
|
|
|
DRILL BIT 3.2 X 145MM 3-FLUTED NEEDLE POINT 03.010.103S
|
Facility
OP
|
$2,523.00
|
|
| Hospital Charge Code |
2966198
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$706.44 |
| Max. Negotiated Rate |
$10,092.00 |
| Rate for Payer: Aetna Commercial |
$2,270.70
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,169.78
|
| Rate for Payer: Aetna Managed Medicare |
$706.44
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,639.95
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,261.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,211.04
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,337.19
|
| Rate for Payer: Cash Price |
$756.90
|
| Rate for Payer: Cigna Commercial |
$2,321.16
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,411.87
|
| Rate for Payer: Health EOS Commercial |
$2,245.47
|
| Rate for Payer: HFN Commercial |
$2,321.16
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,892.25
|
| Rate for Payer: Multiplan Commercial |
$2,018.40
|
| Rate for Payer: NAPHCARE Commercial |
$1,513.80
|
| Rate for Payer: Preferred Network Access Commercial |
$2,321.16
|
| Rate for Payer: Quartz Beloit One Network |
$1,236.27
|
| Rate for Payer: Quartz Commercial |
$1,639.95
|
| Rate for Payer: Quartz Medicare Advantage |
$1,513.80
|
| Rate for Payer: The Alliance Commercial |
$10,092.00
|
| Rate for Payer: WEA Trust Commercial |
$1,387.65
|
| Rate for Payer: WPS Commercial |
$1,868.79
|
|
|
DRILL BIT 3.2 X145MM 700358
|
Facility
IP
|
$1,396.00
|
|
| Hospital Charge Code |
5459548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$684.04 |
| Max. Negotiated Rate |
$1,284.32 |
| Rate for Payer: Aetna Commercial |
$1,256.40
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$739.88
|
| Rate for Payer: Cash Price |
$418.80
|
| Rate for Payer: Cigna Commercial |
$1,284.32
|
| Rate for Payer: Health EOS Commercial |
$1,242.44
|
| Rate for Payer: HFN Commercial |
$1,284.32
|
| Rate for Payer: Multiplan Commercial |
$1,116.80
|
| Rate for Payer: NAPHCARE Commercial |
$837.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,284.32
|
| Rate for Payer: Quartz Beloit One Network |
$684.04
|
| Rate for Payer: Quartz Commercial |
$837.60
|
| Rate for Payer: WEA Trust Commercial |
$767.80
|
| Rate for Payer: WPS Commercial |
$1,034.02
|
|
|
DRILL BIT 3.2 X145MM 700358
|
Facility
OP
|
$1,396.00
|
|
| Hospital Charge Code |
5459548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$390.88 |
| Max. Negotiated Rate |
$5,584.00 |
| Rate for Payer: Aetna Commercial |
$1,256.40
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,200.56
|
| Rate for Payer: Aetna Managed Medicare |
$390.88
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$907.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$698.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$670.08
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$739.88
|
| Rate for Payer: Cash Price |
$418.80
|
| Rate for Payer: Cigna Commercial |
$1,284.32
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$781.20
|
| Rate for Payer: Health EOS Commercial |
$1,242.44
|
| Rate for Payer: HFN Commercial |
$1,284.32
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,047.00
|
| Rate for Payer: Multiplan Commercial |
$1,116.80
|
| Rate for Payer: NAPHCARE Commercial |
$837.60
|
| Rate for Payer: Preferred Network Access Commercial |
$1,284.32
|
| Rate for Payer: Quartz Beloit One Network |
$684.04
|
| Rate for Payer: Quartz Commercial |
$907.40
|
| Rate for Payer: Quartz Medicare Advantage |
$837.60
|
| Rate for Payer: The Alliance Commercial |
$5,584.00
|
| Rate for Payer: WEA Trust Commercial |
$767.80
|
| Rate for Payer: WPS Commercial |
$1,034.02
|
|
|
DRILL BIT 3.2 X 216MM NON-LOCKING SHORT 705032
|
Facility
OP
|
$3,349.00
|
|
| Hospital Charge Code |
5106959
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.72 |
| Max. Negotiated Rate |
$13,396.00 |
| Rate for Payer: Aetna Commercial |
$3,014.10
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,880.14
|
| Rate for Payer: Aetna Managed Medicare |
$937.72
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,176.85
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,674.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,607.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,774.97
|
| Rate for Payer: Cash Price |
$1,004.70
|
| Rate for Payer: Cigna Commercial |
$3,081.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,874.10
|
| Rate for Payer: Health EOS Commercial |
$2,980.61
|
| Rate for Payer: HFN Commercial |
$3,081.08
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,511.75
|
| Rate for Payer: Multiplan Commercial |
$2,679.20
|
| Rate for Payer: NAPHCARE Commercial |
$2,009.40
|
| Rate for Payer: Preferred Network Access Commercial |
$3,081.08
|
| Rate for Payer: Quartz Beloit One Network |
$1,641.01
|
| Rate for Payer: Quartz Commercial |
$2,176.85
|
| Rate for Payer: Quartz Medicare Advantage |
$2,009.40
|
| Rate for Payer: The Alliance Commercial |
$13,396.00
|
| Rate for Payer: WEA Trust Commercial |
$1,841.95
|
| Rate for Payer: WPS Commercial |
$2,480.60
|
|
